Hello everyone and welcome to well tacks on the b.b.c. World Service where a team of journalists tracking down ordinary people everywhere are trying to fix some of the world's big problems I'm to Barry and this week how one seemingly small event in the Netherlands ended up having x. Huge impact on people's lives and work the country up to a much bigger problem and it all starts with the story of a very sick little girl called Evelina which is where our lovely reporter chagrin Ronnie comes in to tell us all about it fatal Iloilo I want to start by telling you the story of one family in Holland Eric his wife and their daughter have Alina. Well. Very nice. And every Monday in Whoville was an ordinary Dutch pick Fama But in October 2003 something happened which was to change the course of his entire life and it was every parent's worst nightmare. From an oval from Holland I am a pig farmer in 2001 Eric's daughter Evelyn I was born with a heart defect she was pretty ill and 2 years later had to be taken to hospital for surgery and then she finds the Emirates bacteria only we have questions what is going to say when I didn't go to hospital she received the routine checks for drug resistant bacteria that all patients get into spittles and they found the superbug m.r.s.a. And then they said Oh that is a big problem and she cannot operate and then start for us the big problem. Results when we are about Yemen as a doctor. That was the end of our world that's not been his mom because our daughter was so sick so ill that yes need the operation but she cannot come to deal spittle. Understand that So m.r.s.a. Is also known as a superbug right precisely to litter It's a type of bike Tyria that's resistant to antibiotics and ice is extremely dangerous if it spreads in hospitals and that's why they sent her home but there was a twist to this story the doctors found that this strain of m.r.s.a. Was also carried by all the members of everything as family and as it eventually turned out by a Around 50 percent of all pig farmers around the Netherlands now this pig m.r.s.a. As it came to be known was spreading rapidly from pics to foreigners to the community and then to hospitals and thousands of people became infected Ok hang on a 2nd here how was the m.r.s.a. Superbug getting from pigs to people Ok so let me give you a bit of context now Erik and other from this in the Netherlands were feeding their pigs antibiotics every day which is pretty standard practice in many countries but the pigs have been built up a resistance to antibiotics and what I believe the situation showed was that this was putting human health at risk before this point no one realized that lifestyle and Morrissey could be passed from animals to people and it was through farmers contact with pigs and also people eating pork that the infection was being passed on now what you need to understand is that this is all about resistance to antibiotics and this was a big wake up call for the whole of Dutch society and alarm bells started ringing. Ok Shikhar if it's cool with you let's pause for a moment and look at the bigger picture people in the Netherlands realize there was a huge problem with antibiotic resistance and it was being passed on from animals to humans so what we're really talking about is the fact there's been a worldwide increase in antibiotic resistance basically we're using that. And now some common infections are not responding to antibiotics treatment anymore. Just a quick science lesson on antibiotics. In 1928 the 1st antibiotic was discovered by Scottish scientist Alexander Fleming and he called it penicillin and since then we've become dependent on them using them to treat everything from the Monia to back you know sis and fall off to care when you have an operation and that some bacteria have developed a resistance to antibiotics and evolved into super bugs like the m.r.s.a. That little girl Evelina which Right exactly now super bugs like m.r.s.a. Are life threatening and they're very hard to treat and it means that people can die not from the original disease but because they can fight off an infection and I didn't realize the magnitude of this problem until I spoke to this man I would say that it's way bigger than most rats it's or isn't enough course part of the policymaker problem is that it's not as visible as some of these remarkable threats to human life that we have today but we're certainly much bigger Unca multiply at a scale of much bigger than them was say with all the challenges including servicing that's Lord Jim O'Neill when he talks people listen he's a British economist best known for coining the famous I can image like bricks which stands for Brazil Russia India and China but the reason we spoke to him for world hacks is that in 2014 he was commissioned by the British government to chair a formal independent review into resistance to antibiotics Jim O'Neill says that already today around $50000.00 people a year are dying in Europe and the us from resistance to antibiotics that's close to double the number who died from the Ebola outbreak and it gets worse to do a. His report found that by 2050 there could be 10000000 people that's 10000000 a year dying from diseases that could have been treated by antibiotics we could end up with a world where we could get some time to need a court from just falling over walking down the streets where you can't do anything about the infection because the drugs won't work so I don't know about you but offering up this is really scary stuff we've talked about humans becoming resistant to antibiotics but why don't we talk a little bit more about the use of antibiotics on animals that's part of the wider problem isn't it after all every nickel m.r.s.a. From the pigs on her dad's farm that's right now the wide scale use of antibiotics in intensive farming is pretty controversial stuff pigs and chickens for example can get pumped full of antibiotics to fight off infections that can take hold in overcrowded farming conditions now in some countries antibiotics are also given to fatten animals up because they can do that although that's now banned in Europe but even in Europe the use of antibiotics in farm animals is 80 times higher than in humans the point is that this practice of giving animals and people won't excuse making them and us more resistant and it can get into our guts through the meat on our plate Well that sounds delicious. Sugar Why can't promise just stop using antibiotics Surely that's the solution goodbye superbugs Yes you'd think so wouldn't you but it's not so simple to get farmers to change their ways and the reason is that they're worried about the bottom lines they fear that reducing antibiotic use would lead to their farm animals dying of disease and many of them want to bardic skeptics kind of like climate skeptics so they don't accept the link between farms and human health problems although the fact is that the vast majority of scientists believe there is a link. Ok so sugar you were telling me the story of Eric and his daughter of Lena in the Netherlands that's good about that yes that's because the Netherlands is a huge success story they've managed to reduce the use of antibiotics in animals by 65 percent what's interesting is that they used to be the highest uses of antibiotics in lifestyle in the whole of Europe so that's why it's being called the Dutch success model and one of the key figures in this story is Eric Evelyn is that because what happened to his daughter got him on a mission to change what he and other pig farmers were doing in the evidence and then I said 3 must work together with the hospital for look rats coming from and how we can have this right and so he went in search for an alternative head to them beers is a director of the Dutch that 3 medicine or Thora t. And she remembers a time the story of Evelyn a spread through the farming community Eric went from town to town talking to other farmers with one single message what happened to him could easily happen to them if they didn't do something about it and then he started to be kind of invested or and to warn farmers and the newest main topic is that they have to change something on the farm and then the 2nd pick was that you could use probiotics to prevent the use of and to microbial So what did Eric end up doing differently on his farm and well all probiotics probiotics a basically good bacteria which balance out the bad bacteria rather than trying to kill them and the big change that Eric made in his farming practice is that instead of routinely using antibiotics in animal feed as he had done in the past he started spraying his animals with probiotics and he and his family even used them on themselves in the house Hugh and me. It's not quite nice it's not like lavender. It's just this infected my mind not the fact I'm strange good bacteria. You sprayed all around your home yeah and this acts not as an antiseptic it doesn't kill the bacteria you know only that we work together bacteria Yeah we take this production everywhere and in the home in the hospital when they go on holiday we take your c.v. We have it there it us Ok sugar what was going on there Ok let me tell you what Eric showed me it was a whole range of probiotic hygiene products everything from house spray to a hand wash deodorant washing detergent and skin creams that they use in the home for personal use to stay healthy and infection free and on the phone they use probiotics in the pics water and then 3 times a week they sprayed the whole farm and the pigs themselves with probiotics Now that was a totally new way of thinking for them and they are 100 percent convinced that it works after one whole of Europe was. 2011 we have 95 percent. Tax revenues on the farm 95 percent and also we are all of them are is a negative in the family Ok so let me get my head around there's just by using the sprays they had a 95 percent drop in the use of antibiotics on the farm Yes indeed that's what he told me and he also said that this was actually no more expensive than using antibiotics to keep East pigs healthy right so this sounds like a huge success he has healthy pigs and m.r.s.a. Free family it's not costing him any extra money you know was this the big solution to this works changed Netherlands actually no despite all of this Eric said that it's been very hard to convince other farmers to take this method out because there's not that much trying to prove and it doesn't. Deliver immediate results as antibiotics do so only around 10 percent of Dutch farmers are using probiotics However they were listening to Eric's message about the need to drastically reduce their antibiotics but they did it using other ways. Hello you say I think it's you I'm sure coop Ok to learn I want you to come with me a short drive away in the small town of peers in the Netherlands only a few miles from Eric's form is another pic pharma called good it was the luck and if they fix it for no it's my 1st time I've never been on it's a form not good it was galvanized into action because of everything in this case he's another key player in the story and his big insight was this that healthy flakes don't need antibiotics any more than healthy people do so 1st you have to make your peace healthy then you can reduce your antibiotics not the other way around all right so what was Governor solution his solution actually is all about hygiene Let's hear. How you see our farm right here 600 South. We have another stable with 2000 thanks good is a tall slim man in his fifty's he's balding with a grey beard glasses on a really friendly face and I couldn't help noticing his t. Shirt with the name of his farm and get this De'Monte on the front or gosh well he's quite a character so he explained to me how his new hygiene system works what we changed in this in this new stable and therefore our journey Joyce and our flood ground you see that there's 4 different colors we use in average always use different clothing different moods saw to reduce. The chance that 3 very organisms or bacteria from the ones known to another so I couldn't actually get up close to the pigs because that's really part of the whole point. You don't allow people from outside to come in that could potentially bring in infections and bacteria with them however there is a public viewing out early and I was able to see the different sections and the pigs through that glass screen what he explained is that they have different colored zones red yellow and blue and in each zone he has pigs of different ages so when a full on a goes from one zone to another he has to change all his overalls his boots everything and the point of that is that he doesn't carry any bacteria from one zone to another so there's any infections on the phone they don't get transmitted and spread around so Herb it's all about extreme hygiene right but it surprises me that he wasn't doing this before yes you think so but he was and and neither was anyone else and in fact a good bit told me that he had to have the whole new form installed with the different hygiene systems and the different sounds in place he also told me that mixing animals up of different age groups is bad before as soon as the piglets were born they'd be taken away from their mom and they'd be taken to a new pen with all the pigs where they'd fight get injured and their wounds would get infected with bacteria so what good is he keeps the piglets with the moms until the 10 weeks old and that's a total change from the old system when you don't make some up you keep the flock together they don't fight they get sick what do you do we treat that when I'm sick I hope that my doctor will treat me with antibiotics when it's not religion as that's what we do want a big big or a bigger they say oh we treat it well you needed to treat it so you got happier picks up your pics I'm still convinced of that yes or there's a happy pig look like look at my stable release you have your pics like that happy pigs all sounds good how is it more expensive I mean is have to build this huge new building everything did it cost a lot of money to lower your spot on in fact he told me making this new building was his biggest expense. But it's actually paid off because there's less mortality and it's made him more profitable than when he was using antibiotics because his pigs are healthy and so are bit and all his family and still there are for your family say all of them they are my wife's tested twice my employees free and I'm proud of it because that's what we did it for so sure we've heard about these 2 cool farmers ambassador actions but what about the rest of the Netherlands How did the spread Well that's interesting Pont because those around $40000.00 farmers in the evidence and they've all got home port now the way this happened is that after that big scare sparked by the pig m.r.s.a. Outbreak and editing story Herbert brought together a small network of around 11 formats and that's they spent quite a few years trying to work out how to change things through trial and error and learning from each other's mistakes and they finally came up with a system that kept the pigs healthy and allowed them to use less antibiotics and then in 2008 the government heard about what they were doing and they funded a 2 year program to take her to its network all around the country to speak to other farmers about what they were doing and every farmer said how are we going to do it so we've told them what you do this you get more healthy pigs and a result of that you don't need any on the biotics either it's better for yourself it's better for your pics or better story can you tell. When you tell them that your relative is probably having a pretty big problem life threatening when you're going on the way that you do one time he will think oh I have to change my attitude. Well in about a year we had $82.00. To 85 percent of the farmers interested in our system pig farmers bulls or farmers cattle farmers they all were interesting because that's the main story. We have to do something to prevent ourselves our families and the next generation. So this sounds very much like it was a grassroots movement led by individual farmers but did the government's involvement make it more official did they get more pharmacy in the Netherlands to reduce the use of antibiotics actually yes now the government did step up and they played quite an important role in 2009 the then Minister of Agriculture decided to bring in some tough new policies the government introduced a mandatory targets to reduce antibiotics in agriculture by $3050.00 and then 70 percent crucially they also banned the routine preventive use of antibiotics in animal feed so that farmers can only get the antibiotics on prescription from a vet when they need it also and this is really important each farmer has to register and work with one that only so that means that farmers can't go shopping around for antibiotics from other that's so it was a combination of all these measures and supporting people like Eric and have it in spreading the message to all other farmers in the country which really brought about a big momentum and that huge 65 percent drop in the use of antibiotics. Ok Let's talk money if we have to we do have to sow her but made a profit but what are all the farmers they have to make a living they have to explore that maybe one to them Well actually to do it or it didn't affect their productivity and reducing antibiotics has not affected their profits the Netherlands where the biggest exporters of meat in the whole of Europe and they still are. Sugared this all sounds great but I have been doing some reading and it looks like many other countries are going in the opposite direction to the Netherlands places like China or Brazil. Russia India and South Africa are predicted to double their use of antibiotics by 2030 and so resistance looks like it might spread Yes and that is a scary prospect but some of the countries have also been successful in reducing antibiotic resistance like Denmark for example but it took the Netherlands years to come up with their methods and is the world running out of time what can we take away from your story well what the Netherlands story tells us overruled is that one single event and just one or 2 forms can really turn things around for a whole country and in theory the rest of the world could take what they've done and replicated as much as they can on their farms on that note I'm going to give the last word to Lord Jim O'Neill Now if you remember he was asked to chair that review into antibiotic resistance I wanted to know what he thought was a secret at the success of the Dutch model I think they'll answer is strangely quite simple I think a few key people in the Netherlands and Denmark basically realise that this is a huge problem and. They have to treat it with the seriousness that is usually reserved for other forms of pulses such as you know defense of the country . One thing I really want to know and I'm dying to know as a bit into your report was a little girl Evelyn I wish you write me and well to do that you'll be very pleased to know that that little toddler is now a healthy happy 16 year old girl and her operation was a success because the doctors were able to keep her in isolation until her m.r.s.a. Cleared up and then they could operate on her. And it was her. Case is also. I'm happy that that everything after this go. Good yes I do love a happy ending so do I too Lula and that's it from us this week if you want to Hamill solutions then you should check out our back catalogue it's on our podcast called people fixing the world or if you have a solution to share with us we'd love to hear it our e-mail as well and hacks at b.b.c. Don't kowtow u.k. 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